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Related Concept Videos

Schemata01:17

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A schema is a mental construct that organizes related concepts, allowing the brain to process information efficiently. Upon activation, schemata facilitate assumptions about people or objects.
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Personality disorders represent enduring cognition, affect, and behavior patterns that significantly deviate from societal norms. These maladaptive traits often lead to difficulties in various domains, including interpersonal relationships, occupational settings, and overall psychological well-being. Paranoid personality disorder and schizoid personality disorder are two distinct conditions marked by odd or eccentric behavior.
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Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder
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Mechanisms of Change in Day Treatment Group Schema Therapy for Severe Personality Disorders: A Multiple Baseline

Joska van Houten1, Samantha Bouwmeester2, Nathan Bachrach1,3,4

  • 1Department of Trauma Related and Personality Disorders, GGZ Oost Brabant, Helmond, the Netherlands.

Clinical Psychology & Psychotherapy
|May 20, 2026
PubMed
Summary

Schema therapy (ST) effectively treats personality disorders (PDs) by targeting negative core beliefs. Changes in these beliefs and specific schema modes (SMs) are key to reducing PD severity and improving treatment outcomes.

Keywords:
day clinicday hospitalday treatmentgroup schema therapymechanisms of changemediatorspersonality disordersschema therapy

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Area of Science:

  • Psychology
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • Schema therapy (ST) is recognized for treating personality disorders (PDs).
  • However, the specific mechanisms driving ST's effectiveness remain incompletely understood.
  • Clarifying these mechanisms is crucial for optimizing therapeutic interventions.

Purpose of the Study:

  • To investigate the mechanisms of change in day treatment group schema therapy (DT-GST) for severe PDs.
  • To examine the relationship between changes in PD severity, negative core beliefs, and schema modes (SMs).

Main Methods:

  • A multiple-baseline single-case design was employed over 30 weeks.
  • Personality disorder severity was assessed pre- and post-treatment.
  • Idiosyncratic negative core beliefs were measured weekly, while early maladaptive schemas (EMS) and SMs were assessed pre- and post-treatment.

Main Results:

  • Reductions in PD severity significantly correlated with decreased negative core beliefs.
  • Negative core beliefs showed strong associations with specific maladaptive (e.g., Punitive Parent) and adaptive (e.g., Happy Child) schema modes.
  • Therapeutic progress was observed across all phases, with significant gains in later stages.

Conclusions:

  • Idiosyncratic negative core beliefs play a pivotal role in reducing PD severity within DT-GST.
  • Changes in schema modes are also important, with a need to reduce Vulnerable Child and Parent modes while enhancing Healthy Adult and Happy Child modes.
  • Further longitudinal research is recommended to fully elucidate ST's change mechanisms.